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41st Anniversary Special: Psych out - Page 2

Its idea is to put psych patients back into the city but help alleviate the misery they might otherwise endure alone or in a maddeningly sterile hospital. It seems to think the hard cases aren't that hard.

"The time and resources devoted to this group of clients in a psychiatric crisis who are not hospitalized represents a cost to the mental health system that is unnecessary and avoidable if the intervention, triage, assessment, and treatment can occur in a community setting," the Progress Foundation's June proposal reads.

"To the extent that there are people who would do better if we really wrapped services around them, shouldn't we all focus on those people who would accept services voluntarily?" Katz asked the committee. "I think to focus a lot of our resources trying to convince people to take treatment against their will as outpatients when so many people would benefit from more loving, positive care, I don't think it's the right priority."

Piers Mackenzie still views Katz's plan as poor public policy. His daughter, then 22, required a brief stay at SF General's psych ward during a sudden mental health catastrophe four years ago. The event politicized Mackenzie, and he has since agitated against attempts by Katz to scale back psychiatric services at the hospital.

"I couldn't think of a more retrogressive step, simple as that," Mackenzie said. "When there's a proven need for more beds than there are presently, to cut them is just plain idiotic. I don't understand it."